Surgical guidance system using hand-held probe with accompanying positron coincidence detector
Inventors
Majewski, Stanislaw • Weisenberger, Andrew G.
Assignees
Jefferson Science Associates LLC
Publication Number
US-9784852-B1
Publication Date
2017-10-10
Expiration Date
2027-02-16
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Abstract
A surgical guidance system offering different levels of imaging capability while maintaining the same hand-held convenient small size of light-weight intra-operative probes. The surgical guidance system includes a second detector, typically an imager, located behind the area of surgical interest to form a coincidence guidance system with the hand-held probe. This approach is focused on the detection of positron emitting biomarkers with gamma rays accompanying positron emissions from the radiolabeled nuclei.
Core Innovation
The invention provides a surgical guidance system that offers different levels of imaging capability while maintaining the same small, lightweight, and hand-held convenience of intra-operative probes. It achieves this by incorporating a second detector, typically an imager, positioned behind the area of surgical interest to form a coincidence guidance system with the hand-held probe. The system focuses on detecting positron emitting biomarkers by capturing the two 511 keV gamma rays accompanying positron emissions from radiolabeled nuclei.
The problem solved by the invention stems from limitations of prior art surgical guidance probes. Traditional hand-held probes operate by detecting the intensity of radioactive signals in the probe's vicinity but suffer from poor sensitivity and poor cancer margin definition. Existing mini-imagers are often bulky (1-3 pounds), obstruct the surgeon's view of the surgical field, and lack co-registration with anatomical detail, limiting their utility. Mechanical support systems introduced to hold such probes exacerbate visual obstruction issues, while smaller field-of-view devices reduce imaging utility. Other prior attempts, such as scintillator gamma sensors connected via fiber optic guides, still face limited field of view and obstruction issues.
The invention addresses these shortcomings by combining a small, easily manipulated hand-held probe with a larger coincidence imaging detector placed opposite the surgical area, such as behind the patient or organ. This geometry allows a larger surgical field to be imaged, offers improved directional guidance based on coincident detection of paired annihilation gamma rays, and reduces background signals from surrounding tissue. The system also includes fast hardware processors and software for immediate feedback to the surgeon to assist in differentiating between neighboring hot spots and guiding the probe precisely to areas of increased biomarker uptake.
Claims Coverage
The patent includes one independent claim that covers a comprehensive surgical guidance system integrating a multi-layer hand-held detection probe, a coincidence detector, signal processing hardware, and a coincidence imager.
Multi-layer hand-held detection probe configuration
The probe comprises a first scintillator layer converting beta radiation to light with a first pulse shape, a second scintillator layer in optical contact producing a second pulse shape, and a gamma scintillator layer in optical contact producing a third pulse shape, all coupled to a photodetector.
Coincidence detector for detection of paired annihilation gamma rays
A second gamma scintillator layer detects the other 511 keV annihilation gamma ray and produces a fourth pulse shape to enable coincidence detection of the region of interest.
Pulse shape separation processing
Hardware processor separates pulse shapes based on different time decay and amplitude characteristics to distinguish beta and gamma signals effectively.
Coincidence imager for visual display and intensified imaging
The coincidence imager displays a formed image of the region of interest by combining pulse shapes from the hand-held probe and coincidence detector to produce an intensified image highlighting areas of increased biomarker uptake.
The independent claim covers a coordinated surgical guidance system using a specialized multi-layer probe and a coincidence detector with sophisticated pulse shape discrimination and imaging capabilities to enhance detection and localization of biomarker uptake regions during surgery.
Stated Advantages
Provides the greatest detailed view of the surgical area without limiting the surgeon's visual field as seen in prior systems.
Enables a small and light enough system for easy surgeon manipulation without cumbersome support systems.
Delivers immediate on-the-spot feedback via fast hardware and software processing for precise guidance during surgery.
Improves guidance accuracy by differentiating and selectively targeting neighboring hot spots through coincident detection.
Maximizes detection sensitivity by optimal detector geometry, positioning a large coincidence detector opposite a small hand-held probe.
Documented Applications
Surgical removal of cancerous lesions using radiolabeled positron-emitting biomarkers.
Intra-operative guidance during biopsy or surgery involving organs such as breast, head, neck, and extremities, using a flexible coincidence imager configuration.
Prostate cancer surgery with a trans-rectally inserted small coincidence imager placed behind or under the prostate to provide high sensitivity and spatial resolution for cancer margin definition.
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